Deccan Chronicle

Time to wake up to the dangers of sleep apnea

Deccan Chronicle| Joyeeta Chakravorty

Published on: June 20, 2016 | Updated on: June 20, 2016

The disrupted sleep pattern is caused by collapse of soft tissue in the airways.

Sleep Apnea has also been linked to heart disease, obesity, hypertension, dyslipidemia (abnormal levels of cholesterol fat in blood) and insulin resistance.

Sleep Apnea has also been linked to heart disease, obesity, hypertension, dyslipidemia (abnormal levels of cholesterol fat in blood) and insulin resistance.

Do you find yourself falling asleep involuntarily? Don’t brush it off, you just might have Obstructive Sleep Apnea, a condition in which  breathing pauses as a person sleeps. OSA is the cause of a number of vehicle accidents and is also linked to diabetes, high blood pressure and cardiac trouble. With very little information available about the condition, Obstructive Sleep Apnea is now being called the ‘silent epidemic’, with its possibly fatal consequences.

"I used to feel sleepy all through the day and once even dozed off while driving to work. It was an alarm call for my family and I. Realising that something was very wrong, I decided to  register for a sleep test at one of the labs in the city," says Mr Dhruv Mukherjee, who works in an MNC in the city.

He is only one of the 60 odd people, who have opted for their sleep patterns to be studied at a sleep lab in city. "We have had cases of a driver dozing off while driving, people dozing off while watching television and so on. Sadly, light sleep or obstructive sleep has never been given the importance it deserves," says Dr HB Chandrashekar, head of the department of pulmonary medicine at the Mahavir Jain Hospital.

Read: Guest column – ‘Ignoring symptoms detrimental to overall health’

But now sleep study, a relatively new concept, seems to be catching on in the  IT city, where many in high stress jobs appear to be finding sleep a luxury. The sleep labs at Mahavir Jain Hospital alone do some 50 to 60 studies a month. "We have diagnosed some 8000 patients over the past 10 years and see around 400 cases annually," reveals Dr Chandrashekhar , who also heads  two other sleep labs at the Columbia Asia Hospital. "The number of people opting for sleep studies today is huge and hence the waiting list  of two weeks," he explains.

"Surprisingly many of our patients   have woken up as many as 100 times in an hour during a sleep study. Basically their quality of sleep is disruptive , often due to the repetitive choking of the upper airway," the doctor reveals. The interruptions in sleep, called apneas,  are caused by the collapse of the soft tissue in the airway, which prevents oxygen from reaching the lungs, explain experts. The reasons could range from weak muscles in the airway, to a large tongue and even obesity.

sleep apnea

Going by various medical studies  the problem is by no means so small as around 30 to 40 per cent of the working population in the country, particularly  corporate executives, medical professionals and cops apparently don't sleep well. Disturbingly, Obstructive Sleep Apnea (OSA), characterised by respiratory difficulties during sleep, affects 9 to 21 per cent of women and 24 to 31 per cent of men.

The problem cannot be dismissed as there  are various risks associated with poor quality sleep. In fact, experts warn that by 2020, around 3.5 lakh of the anticipated 23 lakh fatalities in vehicle accidents will result from sleepiness or fatigue. Sleep Apnea has also been linked to heart disease, obesity, hypertension, dyslipidemia (abnormal levels of cholesterol fat in blood) and insulin resistance.

"Sleep disorder is a silent epidemic. But few people suffering from it even know about the condition and even fewer  seek treatment for it," experts regret. Says Dr Ravindra Mehta of the Apollo Hospital, Jaynagar, "If anything has been taken for granted this millennium, it is human sleep. Sleep, we have to understand is one-third of human existence, and the fuel which keeps you going. Both inadequate and poor quality sleep can affect quality of life  and cause disease, which in turn affects sleep quality. This sleep-disease interaction sets the stage for chronic ill-health."

What is a sleep study?
As a first step a comprehensive evaluation of the patient’s snoring history, blood pressure, obesity, and throat condition is done. Later the patient fills up a Sleep Apnea questionnaire  and is subjected to a clinical examination. An eight hour long study follows, monitoring the patient's sleep activity and brain movement by connecting electrodes to the brain, muscles, heart.

sleep apnea

OSA often linked to cardiac problems
A  2015-16 study by Philips Healthcare India has revealed that more than 53 per cent of Sleep Apnea suspects in the country are already suffering from either diabetes or high blood pressure, which is significantly higher than the 21 per cent suffering from these conditions in the non-suspect population.

The survey also found that 14 per cent of those suffering from the disorder  had cardiac problem as against only 6 per cent of those who didn’t. Its findings have only re-emphasised the correlation between Sleep Apnea and the risk of high blood pressure, obesity and irregular heartbeats, among other health problems. "Sleep Apnea should not be neglected as it is linked to many diseases like high blood pressure, seizures, heart attacks and obesity," stresses Dr H B Chandrashekar, head of the department of pulmonary medicine at the Mahavir Jain Hospital.

The number of people in India suffering from OSA is highly underestimated, regrets Dr KS Satish, consultant pulmonologist with Vikram Hospital, and Fortis Hospital on Cunningham Road.  "Studies suggest that prevalence of OSA in the Indian population is about 13 per cent with the incidence being three times more in men than in women. But of the 13 per cent only 4 per cent go to a doctor with symptoms, leaving a majority of the population undiagnosed and untreated," he adds with concern. Calling Obstructive Sleep Apnea a potentially serious disorder, he  strongly advises people to immediately consult  a doctor if they spot any of the warning signs in their sleep patterns.

Philips Heathcare has established 300 Sleep Labs across India

  • Approximately 35,000 patients are treated at these sleep labs per year
  • People diagnosed in 2015 : 50,000, people treated for Sleep Apnea in 2015 : 15,000.
  • Distribution : North: 40%, East: 10%, West: 25%, South: 25%
  • New clinical segments that have started recognizing sleep patients – cardiology, diabetes, ENT, psychiatric care.
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